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Dr.Saleem
Dr.Saleem, Doctor
Category: Medical
Satisfied Customers: 1361
Experience:  MBBS
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Having daily abdominal pain. Pain under front right ribs,

Customer Question

Having daily abdominal pain. Pain under front right ribs, under front left ribs and in middle of abdomen. Usually pain is 4 or so on a scale of 10 but sometimes a 7 or 8. Pain comes and goes but is there a lot of the time. Having several stools per day; sometimes diarrhea, sometimes "normal" looking; sometimes urgent; always 30 min to 1 hr after eating almost anything. Had normal Hepatobiliary Scan with Ejection Fraction although it hurt like crazy whey the gave the meds to make the gall blader empty. Normal ultrasound of gall bladder and pancreas.
Ant idea what might be going on? Thanks for any thoughts.
Submitted: 3 months ago.
Category: Medical
Expert:  Dr.Saleem replied 3 months ago.

Hello and welcome to JA. I am Dr Saleem, will be right back with the answer.

Expert:  Dr.Saleem replied 3 months ago.

I would like to know for how long have you been having this pain? Has it always been linked with diarrhea ? Is the pain like cramps? Please describe its character? Do you have any acidity issues or indigestion? Any blood in stools ever? Any weight loss?

Expert:  Dr.Saleem replied 3 months ago.

Diarrhea immediately after food can be because of following reasons.

Irritable Bowel syndrome; Features including abdominal cramps, bloating , improvement after passing stool , frequent diarrhea sometimes might be accompanied with alternating constipation.

Osmotic diarrhea that improves only with fasting.

Inflammatory bowel disease; long history of diarrhea with pain usually more towards right lower abdomen, it can also worsen with food.

Customer: replied 3 months ago.
The pain is not always associated with eating. For example, I have had nothing to eat in the past 4 or 5 hours and I am having pain on my right side just below my last rib. I don't have lower abdominal pain. It is an intense sort of stabbing pain for 10 or so minutes then subsides or becomes less intense. It occurs on both sides just below my last rib frequently during the day; more often on the right side. The pain has been going on for 3-4 months now and is getting gradually worse. No blood in stool. Great variability in consistency and color of stools, even in the same day. Colonoscopy 1 1/2 months ago showed 3 polyps but nothing else. I have GERD and have taken medicine for 25 years. No weight loss. Some bloating from time to time.
Expert:  Dr.Saleem replied 3 months ago.

Well pain of duodenal ulcers can present when empty stomach or few hours have elapsed. However alternating diarrhea and constipation does not quite fit in. Does the pain get better when you pass stool?

Expert:  Dr.Saleem replied 3 months ago.

Have you had a stool tests for ova and cysts/ trophozoites just to rule out any worm infestation. Other possibilities include Irritable bowel syndrome and Crohn's disease. A detailed work up is required to figure out the exact cause.

Expert:  Dr.Saleem replied 3 months ago.

Sometimes colonoscopy can be normal in Crohns.

Expert:  Dr.Saleem replied 3 months ago.

Well signing out for now, will be back tomorrow with a comprehensive plan for you. Its 4am here. Getting some sleep.

Expert:  Dr.Saleem replied 3 months ago.

Well sorry for the wait. Most of your symptoms seem to be related to dyspepsia with superimposed IBS. Pain under the ribs on both sides can only explained by excessive gas in stomach . IBS has similiar features and can be aggravated by this .

Another possibility to be ruled out is Giardiasis which may sometimes cause abdominal discomfort, bloating and diarrhea and persist for weeks.

Crohns disease usually has a longer history as its characterized by spells of diarrhea and pains and then completely normal few weeks/ months.other features include occasional mild fever, myalgias etc.

Expert:  Dr.Saleem replied 3 months ago.

Let me know if you want to discuss on this .